Current Issue : October-December Volume : 2022 Issue Number : 4 Articles : 5 Articles
Genetic predisposition is one factor influencing interindividual drug response. Pharmacogenetic information can be used to guide the selection and dosing of certain drugs. However, the implementation of pharmacogenetics (PGx) in clinical practice remains challenging. Defining a formal structure, as well as concrete procedures and clearly defined responsibilities, may facilitate and increase the use of PGx in clinical practice. Over 140 patient cases from an observational study in Switzerland formed the basis for the design and refinement of a pharmacist-led pharmacogenetics testing and counselling service (PGx service) in an interprofessional setting. Herein, we defined a six-step approach, including: (1) patient referral; (2) pre-test-counselling; (3) PGx testing; (4) medication review; (5) counselling; (6) follow-up. The six-step approach supports the importance of an interprofessional collaboration and the role of pharmacists in PGx testing and counselling across healthcare settings....
Community pharmacists in Belgium frequently dispense emergency contraceptive pills (ECPs). However, variable and insufficient counseling practices exist across pharmacies, highlighting the need for standardization and quality improvement strategies. The aim of this project was to develop and test an ECP dispensing protocol for pharmacists. An ‘experience-based’ co-design approach involving academic and practicing pharmacists was applied, followed by a 4-month test period and interviews to assess users’ experiences. In total, eight geographically dispersed pharmacies participated. Pharmacists (n = 15) reached a consensus on most items to be included in the protocol, which was subsequently tested in seven pharmacies, with overall 97 registered ECP conversations. Pharmacists considered the protocol complete but felt that not all items should be mentioned/questioned during all conversations. They suggested only subtle modifications to be made prior to delivering a final protocol ready for nationwide distribution. Despite attributing positive effects to having a protocol, no single pharmacist ‘actively’ used it at-the-counter but used it instead as a ‘checklist’ after the encounter. Pharmacists found that the paper-based format of the protocol hindered protocol-based dispensing. Future research is needed to provide evidence on the actual benefits of protocol application, as well as to identify factors influencing the implementation of ECP dispensing using a software-integrated protocol....
Zimbabwean pharmacists undergo university level education to understand the biochemical mechanisms and actions of medicines but are limited in their scope of practice. They are called medicines experts, yet they are not allowed to apply their specialized knowledge independently in direct patient management. We aim to obtain Zimbabwean pharmacists’ perceptions on extending their scope of practice and to evaluate the Zimbabwe pharmacy honours degree curriculum to determine the competencies covered and whether these are in-line with an extended scope of practice. Qualitative semi-structured interviews with selected pharmacists were conducted to gather perspectives on the BPharm (Hons) curricula and extending pharmacists’ scope of practice. A desktop review of the pharmacy curricula was also conducted to determine competencies covered. The results showed that pharmacists are keen to extend their scope of practice but the curriculum does not equip them with the required exit level competencies. “The pharmacist is obviously not equipped currently but needs to be involved in direct patient care such as identifying and managing medicine therapy problems, prescription extension, ordering and reviewing laboratory data and administration of vaccines and immunizations”. There exists an opportunity for pharmacists to extend their scope of practice in order to achieve universal health coverage....
Objective: To understand how physicians and nurses evaluate Japanese pharmacists’ observed competencies and to explore potential new roles for pharmacists during COVID-19. Methods: A web-based Japanese survey with 25 items assessing physicians’ and nurses’ workplaces and the degree of their relationship with pharmacists in their daily work was conducted (Intage, Inc., Tokyo, Japan) in Japan in June 2021 (for one week beginning on 22 June). The survey asked physicians and nurses whether pharmacists had the required professional competencies and whether the needs of physicians and nurses were met by pharmacists in their workplaces. The scored questionnaire data, which used a Likert scale, were calculated as the mean and standard deviation (S.D.). The perception assessment scale used four levels (1, Agree; 2, Slightly agree; 3, Slightly disagree; and 4, Disagree). Results: This perception study ultimately obtained responses from 304 physicians and 336 nurses. Most pharmacists’ competencies were evaluated as “Agree” or “Slightly agree” by the physicians and nurses. However, the competencies for “Fundamental basic science” and “Prescription analytical skill or case analytical skill” were evaluated significantly lower by physicians than by nurses (Mann–Whitney U test, p < 0.01). Regarding physicians’ and nurses’ needs from pharmacists, nurses hoped that pharmacists could play a greater role as healthcare professionals in response to all items; in contrast, physicians hoped that pharmacists could play a greater role as healthcare professionals in response to five items. The common items were related to the role of healthcare professionals in the community. Conclusion: Our research is necessary for facilitating interprofessional collaboration and reflecting these results in pharmacy education by allowing physicians and nurses to assess the competencies of pharmacists and to understand their needs; however, these data are from only one country....
FASTHUG is a mnemonic used by intensive care physicians to ensure the proper management of patients admitted to an Intensive Care Unit (ICU). FASTHUG-MAIDENS is a modified version that incorporates key pharmacotherapeutic elements such as delirium management, drug dosing, and drug interactions for an appropriate medication assessment of critically ill patients. An analytical cross-sectional study of hospitalized patients was carried out to determine aspects related to the pharmacotherapeutic management of critically ill patients that required to be optimized, to design and implement a protocol based on the FASTHUG-MAIDENS mnemonic. A total of 435 evaluations were performed to assess the status of current critical patient management. The main parameters with opportunities to be improved were analgesia, feeding, and sedation. With the implementation of MAIDENS, the parameters of analgesia, sedation, and thromboprophylaxis showed an increase in the percentage of optimal management. Furthermore, 103 drug-related problems were detected, and most of them were associated with feeding (21.3%), glucose control (11.7%), and delirium (9.7%). The FASTHUG MAIDENS protocol implementation allows for the evaluation of more vital aspects in the management of critically ill patients. The daily review of patients admitted to the ICU by a clinical pharmacist (CP) using the FASTHUG-MAIDENS checklist instead of the FASTHUG mnemonic facilitates the identification of DRPs for the performance of possible interventions by the CP to improve the pharmacotherapeutic management....
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